ZINC SULFATE SUPPLEMENTATION IN CHRONIC RENAL FAILURE PATIENTS REQUIRING HEMODIALYSIS.
AuthorTHOMPSON, JOAN SILVERMAN.
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PublisherThe University of Arizona.
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AbstractThe effects of 18 milligrams elemental zinc as zinc sulfate were investigated in 24 hemodialysis patients during a double blind study. The study was conducted at two different dialysis centers in Utah. Each patient was evaluated for a 12 week period. The effects of zinc supplementation were evaluated using the parameters of serum zinc, hair zinc, dialysate zinc, and objective and subjective taste evaluation procedures. To possibly clearify the above determination in zinc status, copper determination were made of the same parameters. In addition, determinations of serum ferritin, transferrin and iron levels were made. A three day diet record was used to document the dietary intakes of calories, protein, and zinc as well as indicate the balance of food groups in the diets. Patients were evaluated biweekly throughout the study period. There were a total of six evaluations made on each participant during the investigation. Complete data were collected on six patients in the treatment group, and on ten patients in the control group. Even though the sample size was small, results were very steady and values fell within narrow ranges for most parameters examined. The mean baseline serum zinc value (n = 24) was 56 micrograms per deciliter. Patients, by this value would be classified as zinc deficient. However, the hair zinc levels were within the normal range, and no other signs or symptoms of zinc deficiency were evident in any patient, other than altered taste. There were no differences between pre and post dialysis serum zinc levels, nor were there any consistent increases in zinc levels cleared from the plasma during dialysis. There were no increases seen in the serum zinc or hair levels in response to zinc supplementation. Furthermore, there was no significant improvement in the taste acuities of the treatment group patients compared to the controls. The low serum levels maintained were probably due to the redistribution of body zinc known to occur in uremia. Most patients improved their taste test scores. This displayed the learning phenomena that was inherent in the taste testing technique. Furthermore, hemodialysis patients and the failure of many subjects to identify all four tastants (sweet, sour, bitter, and salt) correctly. Daily dietary intakes of high bioglogical value protein and zinc by the patients were less than the amounts recommended by the National Dietary Counsil and the physicians. However, the daily intakes of protein (55 grams) and zinc (7.9 milligrams) were not limited to the level where deficiency signs or symptoms of either nutrient were seen. Copper serum levels were all within the normal range. The mean baseline level for all patients was 113 micrograms per deciliter. Copper status appeared unaffected by uremia or hemodialysis. Body stores of iron, determined by serum ferritin levels, ranged from possibly indicating iron deficiency to iron overload. The body iron stores did not correlate with patients’ responses to the oral zinc supplementation.
Degree ProgramNutritional Sciences